ChatGPT vs rheumatologists: cross-sectional study on accuracy and patient perception of AI-generated information for psoriatic arthritis.

Abstract

Patients with rheumatic diseases frequently turn to online sources for medical information. Large language models, such as ChatGPT, may offer an accessible alternative to conventional patient‑education resources; however, their reliability remains poorly explored. We conducted an exploratory, descriptive comparison to examine whether ChatGPT-4 might provide responses comparable to those of experts. Seventy-six psoriatic arthritis (PsA) patients generated 32 questions (296 selections) grouped into 6 themes. Each question was answered by ChatGPT-4 and by 12 Italian PsA specialists (each drafted 2-3 answers). Fourteen clinicians, The 14 clinicians scored the accuracy and completeness of AI and human-generated answers, rated accuracy (1-5 Likert scale) and completeness (1-3). Interrater reliability was calculated, and mixed-effects ordinal logistic models were used to compare sources. In a separate arm, 67 PsA patients reviewed 16 randomly selected answer pairs and indicated their preference. Readability was assessed. No formal sample size calculation was performed; P values were descriptive and interpreted alongside effect sizes and 95% CIs. Patients most frequently sought information on prognosis/comorbidities (54/76, 71.1%), therapy strategy (48/76, 63.2%), and treatment risks (38/76, 50.0%). Accuracy appeared comparable between ChatGPT and experts, but ChatGPT scored lower in completeness. Accuracy was lower for pregnancy/fertility, with no clear relevant differences in other domains. ChatGPT answers were chosen 491/998 times (49.2%), clinician answers 343/998 times (34.4%), and no preference 164/998 times (16.4%, P < .001), with a relative preference for ChatGPT responses in prognosis and therapy. ChatGPT responses were, on average, more readable across indices. In this exploratory study, ChatGPT-4 appeared able to generate accurate and readable responses to PsA-related questions and was often preferred by patients.